title: The hepato-pulmonary-cutaneous syndrome: description of a case and suggestion of a unifying hypothesis.
abstract: We report a 54-year-old patient with the association of hepatic dysfunction with cyanosis, severe hypoxemia, platypnea-orthodeoxia, diffuse cutaneous spider nevi, telangiectasia, palmar erythema, digital clubbing and findings of marked intrapulmonary vascular dilation and arterovenous shunt. The diagnosis of hepato-pulmonary-cutaneous syndrome, a term we think more appropriate and inclusive than that of hepato-pulmonary syndrome for this clinicopathological picture, is proposed. The putative underlying mechanism for these connected pulmonary and extrapulmonary syndromic features is discussed.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Capodicasa
authors.forename: Federica
authors.initials: F
authors.lastname: De Bellis
authors.forename: Christopher
authors.initials: C
authors.lastname: Muscat